Anaemia in patients with cancer: role of inflammatory activity on iron metabolism and severity of anaemia.

Hepcidin has been proposed as an important factor in the pathogenesis of the anaemia of chronic disease (ACD). The aim of this study was to assess the relationship between anaemia and inflammatory activity in patients with solid tumours. Patients were classified as having iron deficiency anaemia (IDA) (hypoferremia and hypoferretinemia), ACD (hypoferremia, normal or increased serum ferritin) and anaemia related to cancer (ARC) (no abnormalities in iron status). Serum pro-hepcidin, IL-6, C-reactive protein (CRP) and iron status parameters were measured using commercial kits. CRP and IL-6 levels were significantly higher in patients with ACD when compared to IDA, ARC and non anaemic patients (P < 0.005). Serum pro-hepcidin levels were not different among all studied groups (P = 0.138). A negative correlation was observed between haemoglobin and serum ferritin, CRP and IL-6 levels only in group of ACD. Serum pro-hepcidin concentrations were not correlated with degree of anaemia or iron metabolism parameters. According to our results the inflammatory activity represented by high levels of IL-6 and CRP are involved in the pathogenesis of ACD, probably due to the action of inflammation on iron metabolism, but not in ARC. It was not possible to demonstrate a significant effect of pro-hepcidin on the anaemia in cancer patients.

Clinical comparison of cellulose and expanded polytetrafluoroethylene membranes in the treatment of class II furcations in mandibular molars with 6-month re-entry.

The present study compared two barrier membranes, ePTFE and cellulose, used to treat Class II furcations in mandibular molars. Fifteen patients with no history of systemic diseases and presenting matched pair defects were selected. The following soft tissue measurements were taken at baseline (after the hygienic phase), and 6 months after surgery: gingival recession, probing depth, clinical attachment level, and width of keratinized tissue. At the time of membrane placement, and 6 months later (re-entry), the following hard tissue parameters were recorded: cemento-enamel junction (CEJ) to alveolar crest, CEJ to base of osseous defect, alveolar crest to base of osseous defect, and horizontal defect depth. According to the surgical protocol, the ePTFE membranes were completely covered by the flaps (subgingival placement), whereas the cellulose membranes extended 1 mm coronal to the gingival margin (supragingival placement). Healing was uneventful in all cases and membranes remained in place for 4 weeks. Data were analyzed using the Wilcoxon signed-rank test at the 5% level of significance. No statistically significant differences were found between the ePTFE and cellulose membranes, respectively (in mm): probing depth reduction (2.87+/-1.0 versus 3.27+/-1.1), gain in attachment level (2.53+/-1.2 versus 2.8+/-1.3), defect fill (3.0+/-1.4 versus 4.0+/-2.3), horizontal furcation fill (2.87+/-1.1 versus 2.93+/-1.0), alveolar crest resorption (2.4+/-10 versus 2.73+/-1.2), and intrabony defect fill (0.6+/-1.2 versus 1.27+/-1.7). We conclude that both ePTFE and cellulose membranes are effective, not showing statistical differences in efficacy. A larger study may be necessary to show differences in efficacy and adverse effects.

Manifestations of insulin-dependent diabetes mellitus in the periodontium of young Brazilian patients. A 10-year follow-up study.

Eight female and 3 male patients from a group of 30 patients studied 10 years earlier and who had received no periodontal treatment during this period, in order to evaluate the progression of untreated periodontal disease in patients with insulin-dependent diabetes mellitus, were evaluated in terms of plaque accumulation, gingival inflammation, probing depth, and alveolar bone loss. The total number of dental surfaces that presented clinically detectable plaque deposits increased significantly (29% to 43%; P < 0.01; chi 2 = 46.36). Site-specific comparisons for plaque index between studies showed a significant variation (P < 0.01) in the upper arch only for palatal surfaces and in the lower arch for the buccal and lingual surfaces. The total dental surfaces with inflamed surrounding gingiva increased from 11% to 33% in this study (P < 0.01; chi 2 = 175.78). Site-specific comparison for gingival index showed a significant variation for all upper surfaces, while such difference for the lower arch was significant only for the buccal and lingual surfaces. The arithmetic means for the probing depth for the upper buccal, upper palatal, lower buccal, and lower lingual surfaces increased significantly (P < 0.01). The arithmetic means of alveolar bone loss also increased significantly for the upper posterior and lower regions (P < 0.01) and for the upper anterior and lower anterior regions (P < 0.05). The correlation between age and probing depth was significant only for the upper palatal region (P < 0.01). The correlation between age and bone loss was significant only for the upper posterior region (P < 0.05). The results of this follow-up study suggest that despite little variation in plaque accumulation, gingival inflammation, probing depth, and bone loss increased after a 10-year interval in patients who had received no periodontal treatment during this period.